Oral Ribavirin Therapy for Subacute Sclerosing Panencephalitis

Jw, Ogle; Toltzis, Philip; Wd, Parker; Alvarez, Noberto; Mcintosh, Kenneth; Mj, Levin; Ba, Lauer

doi:10.1093/infdis/159.4.748

Cited by 34 publications

(18 citation statements)

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“…Bunyaviruses, including those that cause Rift Valley fever and hemorrhagic fever with renal syndrome, are particularly susceptible to the antiviral action of ribavirin (24). Systemic ribavirin has been used for the treatment of a variety of viral illnesses, including Lassa fever, measles, and hepatitis A (12,13,20,22,30,34,35). Aerosol ribavirin is currently licensed in the United States for the treatment of respiratory syncytial virus infections in children and has been demonstrated to be useful in the treatment of influenza viruses A and B (15,26,34,35).…”

mentioning

confidence: 99%

Safety, tolerance, and pharmacokinetics of systemic ribavirin in children with human immunodeficiency virus infection

Connor¹,

Morrison²,

Lane³

et al. 1993

Antimicrob Agents Chemother

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Eleven pediatric patients, aged 1 to 10 years and with symptomatic human immunodeficiency virus infection, were treated with 6 or 10 mg of oral ribavirin per kg of body weight daily for 60 days. Safety and pharmacokinetic parameters were monitored; five children had comprehensive pharmacokinetic evaluations. The children tolerated the drug well, and treatment was not associated with any clinically significant adverse effects. Peak concentrations in plasma of 2.5 and 3.0 ,uM were reached at 90 min after single oral doses of 6 and 10 mg/kg, respectively. The mean systemic availability of oral ribavirin was 42.3%. After 60 days of ribavirin administration, mean trough concentrations in plasma of 2.6 and 4.1 ,uM were obtained. Ribavirin penetrated well into the cerebrospinal fluid, achieving 70% of the concentration in plasma at steady state.

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mentioning

confidence: 99%

Safety, tolerance, and pharmacokinetics of systemic ribavirin in children with human immunodeficiency virus infection

Connor¹,

Morrison²,

Lane³

et al. 1993

Antimicrob Agents Chemother

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“…In humans, oral ribavirin therapy for subacute sclerosing panencephalitis failed to show clear improvement in the neurological status of either of two patients (12). These data suggest that ribavirin is not effective in treating viral encephalitis when administered by conventional routes.…”

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confidence: 90%

“…Although ribavirin has been shown to cross the blood-brain barrier in both mice (4) and humans (1,12), it has not been very effective in preventing neurological symptoms or diseases caused by viruses. In a herpes simplex virus type 1-mouse encephalitis model, ribavirin administered either subcutaneously or intraperitoneally (i.p.)…”

mentioning

confidence: 99%

Aerosol and intraperitoneal administration of ribavirin and ribavirin triacetate: pharmacokinetics and protection of mice against intracerebral infection with influenza A/WSN virus

Gilbert

Wyde

Wilson

et al. 1991

Antimicrob Agents Chemother

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Ribavirin is active in vitro but not in vivo against a number of viruses capable of causing encephalitis. Ribavirin triacetate (RTA), a lipophilic derivative, has been reported to be more effective than ribavirin in protecting animals from encephalitis. By using an influenza A/WSN virus encephalitis model, we demonstrated that RTA administered by small-particle aerosol was able to decrease the death rate and increase the time of survival. To determine if this beneficial effect was due to increased delivery of drug, the pharmacokinetic properties of ribavirin and RTA when administered as an aerosol or by intraperitoneal injection were examined. Aerosol administration of ribavirin or RTA gave significantly higher concentrations of ribavirin in the lungs and serum of mice than did intraperitoneal injection. There was no difference, however, in ribavirin levels when either ribavirin or RTA was administered by small-particle aerosol. In brain tissue, ribavirin concentrations increased with time and did not appear to decrease as rapidly as in lungs and serum. Mean peak ribavirin concentrations in the brain were higher following aerosol administration of ribavirin than RTA, and both were higher than that following intraperitoneal injection of either drug. Administration of ribavirin or RTA by intraperitoneal injection failed to protect mice from a lethal intracerebral inoculation of influenza A/WSN virus, while aerosolized RTA did protect mice. The pharmacokinetics of ribavirin in brain tissue following aerosol administration of either drug did not explain the advantage of RTA over ribavirin in protecting mice from intracerebral infection with influenza A/WSN virus.

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“…Oral ribavirin is also beneficial against Lassa fever and is given as prophylaxis to high-risk contacts of Lassa fever patients (58). Recent small-scale studies have shown that ribavirin crosses the blood-brain barrier well, giving drug levels in the cerebrospinal fluid that are 50 to 100% of those in serum (82,330). For (103,156,294 (73,278).…”

Section: Ribavirinmentioning

confidence: 99%

Antiviral therapy: current concepts and practices

Bean

1992

Clin Microbiol Rev

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Drugs capable of inhibiting viruses in vitro were described in the 1950s, but real progress was not made until the 1970s, when agents capable of inhibiting virus-specific enzymes were first identified. The last decade has seen rapid progress in both our understanding of antiviral therapy and the number of antiviral agents on the market. Amantadine and ribavirin are available for treatment of viral respiratory infections. Vidarabine, acyclovir, ganciclovir, and foscarnet are used for systemic treatment of herpesvirus infections, while ophthalmic preparations of idoxuridine, trifluorothymidine, and vidarabine are available for herpes keratitis. For treatment of human immunodeficiency virus infections, zidovudine and didanosine are used. Immunomodulators, such as interferons and colony-stimulating factors, and immunoglobulins are being used increasingly for viral illnesses. While resistance to antiviral drugs has been seen, especially among AIDS patients, it has not become widespread and is being intensely studied. Increasingly, combinations of agents are being used: to achieve synergistic inhibition of viruses, to delay or prevent resistance, and to decrease dosages of toxic drugs. New approaches, such as liposomes carrying antiviral drugs and computer-aided drug design, are exciting and promising prospects for the future.

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Oral Ribavirin Therapy for Subacute Sclerosing Panencephalitis

Cited by 34 publications

References 0 publications

Safety, tolerance, and pharmacokinetics of systemic ribavirin in children with human immunodeficiency virus infection

Safety, tolerance, and pharmacokinetics of systemic ribavirin in children with human immunodeficiency virus infection

Aerosol and intraperitoneal administration of ribavirin and ribavirin triacetate: pharmacokinetics and protection of mice against intracerebral infection with influenza A/WSN virus

Antiviral therapy: current concepts and practices

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